Association of Rumination and Metacognition with Posttraumatic Growth in Parents of Children with Cancer.

OBJECTIVE: The primary objective of this study was to examine the association of rumination, metacognition, and posttraumatic with growth in parents of children diagnosed with cancer. DATA SOURCES: The study adopted a descriptive correlational design, and participants (N = 103) were parents of children with cancer. The study was conducted online through the social media platforms of three cancer associations. Data were collected using the Metacognitions Questionnaire-30, the Event Related Rumination Inventory, and the Posttraumatic Growth Inventory. CONCLUSION: The findings revealed a positive correlation between deliberate rumination and metacognition with posttraumatic growth, while a negative correlation was observed between intrusive rumination and posttraumatic growth. Furthermore, deliberate rumination, intrusive rumination, and metacognition collectively accounted for 30% of the variance in posttraumatic growth among parents of children with cancer. These results underscore the significant influence of rumination and metacognition in facilitating posttraumatic growth in this specific population. Consequently, interventions aimed at fostering deliberate rumination hold substantial potential for promoting posttraumatic growth among parents of children diagnosed with cancer. IMPLICATIONS FOR NURSING PRACTICE: This research guides nurses in addressing rumination, metacognition, and posttraumatic growth in parents of children with cancer. By adopting a holistic approach, nurses can enhance parents' well-being and resilience in the face of a child's cancer diagnosis.

Dispositional mindfulness predicting psychological adjustment among college students: the role of rumination and gender.

OBJECTIVE: This study examined rumination as a mediator of the relationship between dispositional mindfulness (DM) and depression, loneliness, and anxiety, while considering gender as a moderator of these mediation models. PARTICIPANTS: Three hundred and nineteen undergraduate students (49.5% female; M = 18.90 years) participated with data collected from January 2018 to April 2019. METHODS: Self-report measures of DM, rumination, symptoms of anxiety and depression, loneliness, and social support were completed. RESULTS: Males scored significantly higher than females on DM, while females scored significantly higher than males on rumination and psychological distress. Rumination mediated the relationship between DM and all adjustment variables. The mediation model predicting depression was moderated by gender, showing stronger effects for females than males. CONCLUSION: Results support rumination as a mechanism underlying the association between DM and psychological adjustment and suggest that targeting both DM and rumination could maximize the effectiveness of mindfulness-based interventions for college students' well-being.

Biology of Perseverative Negative Thinking: The Role of Timing and Folate Intake.

Past-oriented rumination and future-oriented worry are two aspects of perseverative negative thinking related to the neuroticism endophenotype and associated with depression and anxiety. Our present aim was to investigate the genomic background of these two aspects of perseverative negative thinking within separate groups of individuals with suboptimal versus optimal folate intake. We conducted a genome-wide association study in the UK Biobank database (n = 72,621) on the "rumination" and "worry" items of the Eysenck Personality Inventory Neuroticism scale in these separate groups. Optimal folate intake was related to lower worry, but unrelated to rumination. In contrast, genetic associations for worry did not implicate specific biological processes, while past-oriented rumination had a more specific genetic background, emphasizing its endophenotypic nature. Furthermore, biological pathways leading to rumination appeared to differ according to folate intake: purinergic signaling and circadian regulator gene ARNTL emerged in the whole sample, blastocyst development, DNA replication, and C-C chemokines in the suboptimal folate group, and prostaglandin response and K+ channel subunit gene KCNH3 in the optimal folate group. Our results point to possible benefits of folate in anxiety disorders, and to the importance of simultaneously taking into account genetic and environmental factors to determine personalized intervention in polygenic and multifactorial disorders.

Differential Association of Spirituality and Religiosity With Rumination: Implications for the Treatment of Depression.

ABSTRACT: Recent studies have shown that religiosity (R) is associated with lower rates of depression, whereas spirituality (S) is associated with higher rates. Rumination has also been associated with higher rates of depression. Some have hypothesized that rumination mediates the differential association of religiosity and spirituality with depression. We empirically test this hypothesis in a longitudinal, multigenerational sample through associations between rumination and depression, R/S and depression, and R/S and rumination. Cross-sectionally, total rumination scores were predicted by spirituality (standardized ß = 0.13; 95% confidence interval [CI], 0.00-0.26), with subscale (reflection, depression, and brooding) standardized betas ranging from 0.11 to 0.15 (95% CI, -0.03 to -0.29). Cross-sectionally, rumination was not predicted by religiosity. Longitudinally, and consistent with previous findings, religiosity, but not spirituality, predicted reduced depressive symptoms (standardized ß = -0.3; 95% CI, -0.58 to -0.01). The association between spirituality and rumination was driven by millennials. Psychotherapies that target rumination for depression might therefore be especially effective in the millennial demographic.

The efficacy and mechanisms of a guided self-help intervention based on mindfulness in patients with breast cancer: A randomized controlled trial.

BACKGROUND: Mindfulness-based interventions (MBIs) can alleviate psychological distress in patients with cancer. However, face-to-face MBIs may be inconvenient for patients. Therefore, guided self-help interventions may be more accessible. The authors investigated the effects of a guided self-help MBI for depression, anxiety, and sleep disorder symptoms in patients with breast cancer and explored the potential underlying mechanisms. METHODS: One hundred forty-four postoperative patients with breast cancer were randomly assigned to an intervention group (6-week guided self-help MBI; n = 72) or a wait-list control group (routine treatment; n = 72). Self-reported depression, anxiety, sleep disorder symptoms, and rumination and worry as potential mediators were assessed at baseline and postintervention. Outcomes were then assessed at 1-month and 3-month follow-up. The intervention's effects over time and the potential mediating effect were analyzed using generalized estimating equations. The trial was registered at the Chinese Clinical Registry (ChiCTR-IOR-16008073). RESULTS: Significant improvements in depression and sleep disorder symptoms occurred in the intervention group compared with wait-list controls, and the improvements were maintained at 1-month and 3-month follow-up. Changes in rumination and worry mediated the intervention's effects on changes in depression and sleep disorder symptoms. CONCLUSIONS: A guided self-help MBI reduced depressive and sleep disorder symptoms by mitigating rumination and worry in patients with breast cancer. These findings support benefits of this accessible psychological intervention in oncology and provide insight into possible mechanisms of action. The current research contributes to discovering effective and widely accessible means for people with physical health conditions and may remove barriers that otherwise would have precluded participation in face-to-face psychological interventions.

Mindfulness, Posttraumatic Stress Symptoms, and Posttraumatic Growth in Aid Workers: The Role of Self-Acceptance and Rumination.

ABSTRACT: Objective: The risk for aid workers to develop posttraumatic mental problems highlights the importance of reducing the harm of posttraumatic stress symptoms (PTSS) and promoting the benefits of posttraumatic growth (PTG). This study examined the negative relationship between mindfulness and PTSS, and the positive relationship between mindfulness and PTG, and further explored the mediating roles of self-acceptance, intrusive rumination, and deliberate rumination. Methods: Aid workers from the Red Cross Organization (N = 298) were recruited in the study. They completed a series of questionnaires assessing mindfulness, self-acceptance, rumination, posttraumatic stress disorder (PTSD), and PTG. Results: Results showed that mindfulness was significantly and negatively associated with PTSD through positively predicting self-acceptance and negatively predicting intrusive rumination. Mindfulness was significantly and positively associated with PTG, although the mediating effect did not exist because the path between self-acceptance and deliberate rumination was impassable. Conclusion: The mechanisms between mindfulness, PTSD, and PTG were further explored. Limitations and implications for trauma intervention and future research were discussed.

Social Media Exposure and College Students' Mental Health During the Outbreak of COVID-19: The Mediating Role of Rumination and the Moderating Role of Mindfulness.

In response to reports of people experiencing varying levels of anxiety and depression during the outbreak of COVID-19, researchers have argued that exposure to related information on social media is a salient contributing factor. Based on the integrated model of ruminative response style and the diathesis-stress model, it has been suggested that incorporating rumination and mindfulness may elucidate the potential mechanism underlying the aforementioned association. This study aimed to examine the mediating role of rumination and the moderating role of mindfulness in the association between social media exposure (SME) to COVID-19 information and psychological distress. The results from online questionnaire responses of 439 college students from two universities in Wuhan, Hubei Province, showed that rumination mediated the association between SME and psychological distress. Furthermore, mindfulness was revealed as a protective factor that buffered the adverse effect of SME on psychological distress through rumination. These findings advance a better understanding of the formation process of psychological symptoms during the COVID-19 pandemic and provide insights regarding effective interventions for adverse mental health consequences in college students.

Prevent breaking bad: A proof of concept study of rebalancing the brain's rumination circuit with real-time fMRI functional connectivity neurofeedback.

Rumination, repetitively thinking about the causes, consequences, and one's negative affect, has been considered as an important factor of depression. The intrusion of ruminative thoughts is not easily controlled, and it may be useful to visualize one's neural activity related to rumination and to use that information to facilitate one's self-control. Real-time fMRI neurofeedback (rtfMRI-nf) enables one to see and regulate the fMRI signal from their own brain. This proof-of concept study utilized connectivity-based rtfMRI-nf (cnf) to normalize brain functional connectivity (FC) associated with rumination. Healthy participants were instructed to brake or decrease FC between the precuneus and the right temporoparietal junction (rTPJ), associated with high levels of rumination, while engaging in a self-referential task. The cnf group (n = 14) showed a linear decrease in the precuneus-rTPJ FC across neurofeedback training (trend [112] = -0.180, 95% confidence interval [CI] -0.330 to -0.031, while the sham group (n = 14) showed a linear increase in the target FC (trend [112] = 0.151, 95% CI 0.017 to 0.299). Although the cnf group showed a greater reduction in state-rumination compared to the sham group after neurofeedback training (p < .05), decoupled precuneus-rTPJ FC did not predict attenuated state-rumination. We did not find any significant aversive effects of rtfMRI-nf in all study participants. These results suggest that cnf has the capacity to influence FC among precuneus and rTPJ of a ruminative brain circuit. This approach can be applied to mood and anxiety patients to determine the clinical benefits of reduction in maladaptive rumination.

Neural correlates of mindful emotion regulation in high and low ruminators.

Depressive rumination is considered a prominent risk factor for the occurrence, severity, and duration of depressive episodes. A variety of treatment options have been developed to treat depressive rumination of which mindfulness based programs are especially promising. In the current study, we investigated the neural underpinnings of a short mindfulness intervention and mindful emotion regulation in high and low trait ruminators in an ecologically valid environment using functional near-infrared spectroscopy (fNIRS). Participants were randomly assigned to a mindfulness instruction (MT) group or an instructed thinking (IT) group. Participants in the MT group were trained to either focus their attention mindfully on their breath or their emotions, while the IT group focused their attention on the past or future. Afterwards, all participants underwent an emotion regulation paradigm in which they either watched negative or neutral movie clips. During both paradigms cortical hemodynamic changes were assessed by means of fNIRS. Participants in the MT group showed lower activity in the cognitive control network (CCN) during the focus on breath condition in comparison to the focus on emotion condition. Additionally, oxygenated hemoglobin in the MT group tended to be lower than in the IT group. Further, self-reports of emotional distress during the instruction paradigm were reduced in the MT group. During the emotion regulation paradigm, we observed reduced emotional reactivity in terms of emotional distress and avoidance in the MT group in comparison to the IT group. Furthermore, on a neural level, we observed higher CCN activity in the MT group in comparison to the IT group. We did not find any effect of rumination, neither on the intervention nor on the emotion regulation task. The results of this pilot study are discussed in light of the present literature on the neural correlates of mindfulness based interventions in rumination and emphasize the use of fNIRS to track neural changes in situ over the course of therapy.

The effectiveness of mindfulness-based cognitive therapy for reducing rumination and improving mindfulness and self-compassion in patients with treatment-resistant depression.

Introduction Depression is one of the most important psychiatric disorders, and the rate of recurrence is high. The heavy cost burden of depression is probably due to treatment-resistant depression. The purpose of this study was to determine the effectiveness of mindfulness-based cognitive therapy (MBCT) in patients with treatment-resistant depression (TRD). Method The present study was a quasi-experimental study conducted with twenty-four patients with treatment-resistant depression. Participants were selected by purposive sampling and randomly assigned to two groups, an experimental group and a control group. The experimental group received MBCT and antidepressants, while the control group received antidepressants only. The Hamilton and Beck Depression Inventory, Self-Compassion Scale, Thought Rumination Scale, and Mindfulness Scale were administered. The treatment program was conducted in eight sessions; with a follow-up period of one month subsequent to treatment termination. Data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (analysis of variance for repeated measures and Bonferroni's post-hoc test). Results The results showed that MBCT significantly reduced depression and ruminative thinking in the experimental group and also improved mediators such as mindfulness and self-compassion. Patients maintained gains over the one month follow-up period (p < 0.01). Conclusion The present study provides additional evidence for the effectiveness of MBCT for TRD.

The effectiveness of mindfulness-based cognitive therapy for reducing rumination and improving mindfulness and self-compassion in patients with treatment-resistant depression

Abstract Introduction Depression is one of the most important psychiatric disorders, and the rate of recurrence is high. The heavy cost burden of depression is probably due to treatment-resistant depression. The purpose of this study was to determine the effectiveness of mindfulness-based cognitive therapy (MBCT) in patients with treatment-resistant depression (TRD). Method The present study was a quasi-experimental study conducted with twenty-four patients with treatment-resistant depression. Participants were selected by purposive sampling and randomly assigned to two groups, an experimental group and a control group. The experimental group received MBCT and antidepressants, while the control group received antidepressants only. The Hamilton and Beck Depression Inventory, Self-Compassion Scale, Thought Rumination Scale, and Mindfulness Scale were administered. The treatment program was conducted in eight sessions; with a follow-up period of one month subsequent to treatment termination. Data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (analysis of variance for repeated measures and Bonferroni's post-hoc test). Results The results showed that MBCT significantly reduced depression and ruminative thinking in the experimental group and also improved mediators such as mindfulness and self-compassion. Patients maintained gains over the one month follow-up period (p < 0.01). Conclusion The present study provides additional evidence for the effectiveness of MBCT for TRD.

MAP Train My Brain: Meditation Combined with Aerobic Exercise Reduces Stress and Rumination While Enhancing Quality of Life in Medical Students.

Medical students must commit a great deal of concentration and energy during their first 2 years of study, leaving minimal time for self-care. However, once they become physicians, they are in the position of instructing their patients to engage in self-care. Objectives: In this study, first- and second-year medical students participated in a combined mental and physical (MAP) training program with meditation and aerobic exercise that targeted brain health.* Design: Each weekly session began with 30 min of instructional training that emphasized the benefit of the program for brain and body health, followed by 30 min of silent meditation, and ending with 30 min of aerobic exercise. Participants monitored their heart rate to achieve 60%-80% of their personal maximum. Participants engaged in one additional session of MAP training each week on their own. Location and Subjects: First- and second-year medical students were recruited to be participants from the Robert Wood Johnson Medical School (RWJMS) in Piscataway, NJ. Outcome measures: Participants completed questionnaires of depressive symptoms, perceived stress, ruminative thoughts, and quality of life, before and after the training approximately 8-9 weeks apart. Results: After 8 weeks of training and in contrast to students who did not participate (n = 30), the medical students who completed at least 14 sessions out of 16 (n = 17) reported significantly fewer ruminations (-17%), including depressive (-16%) and brooding ruminations (-24%). Ruminations are repetitive thoughts that are typically negative in nature and associated with symptoms of depression. The medical students also reported greater quality of life at the end of training and less perceived stress. The majority (84%) would recommend these types of practices and this one in particular to their future patients. Conclusions: Previous studies have demonstrated that MAP training can reduce symptoms of depression as well as trauma-related cognitions, while increasing oxygen consumption and synchronized brain activity during cognitive control procedures. Overall, MAP training offers a time-efficient and evidence-based means of maintaining mental and physical wellness for students during medical school and into their future, as well as their patients alike.

Connectome-wide search for functional connectivity locus associated with pathological rumination as a target for real-time fMRI neurofeedback intervention.

Real-time fMRI neurofeedback (rtfMRI-nf) enables noninvasive targeted intervention in brain activation with high spatial specificity. To achieve this promise of rtfMRI-nf, we introduced and demonstrated a data-driven framework to design a rtfMRI-nf intervention through the discovery of precise target location associated with clinical symptoms and neurofeedback signal optimization. Specifically, we identified the functional connectivity locus associated with rumination symptoms, utilizing a connectome-wide search in resting-state fMRI data from a large cohort of mood and anxiety disorder individuals (N = 223) and healthy controls (N = 45). Then, we performed a rtfMRI simulation analysis to optimize the online functional connectivity neurofeedback signal for the identified functional connectivity. The connectome-wide search was performed in the medial prefrontal cortex and the posterior cingulate cortex/precuneus brain regions to identify the precise location of the functional connectivity associated with rumination severity as measured by the ruminative response style (RRS) scale. The analysis found that the functional connectivity between the loci in the precuneus (-6, -54, 48 mm in MNI) and the right temporo-parietal junction (RTPJ; 49, -49, 23 mm) was positively correlated with RRS scores (depressive, p < 0.001; brooding, p < 0.001; reflective, p = 0.002) in the mood and anxiety disorder group. We then performed a rtfMRI processing simulation to optimize the online computation of the precuneus-RTPJ connectivity. We determined that the two-point method without a control region was appropriate as a functional connectivity neurofeedback signal with less dependence on signal history and its accommodation of head motion. The present study offers a discovery framework for the precise location of functional connectivity targets for rtfMRI-nf intervention, which could help directly translate neuroimaging findings into clinical rtfMRI-nf interventions.

Effects of modifying interpretation bias on transdiagnostic repetitive negative thinking.

OBJECTIVE: Repetitive negative thinking (RNT; e.g., worry and rumination) is common across emotional disorders, as is the tendency to generate negative interpretations (interpretation bias). Ameliorating negative interpretations via cognitive bias modification of interpretations (CBM-I) reduces worry/rumination, and improves mood in people diagnosed with generalized anxiety disorder (GAD) or depression. We investigated whether these findings generalize to high worry or rumination populations, irrespective of diagnosis, and whether effects are increased by enhancing emotional engagement with training with active generation of positive resolutions of ambiguity and imagery. METHOD: Community volunteers with excessive worry and/or rumination, who were above clinical cut-off on anxiety and/or depression measures, were allocated to an active control condition (n = 54), interpretation training condition with prior activation of RNT (CBM_RNT; n = 54), or training condition augmented with positive outcome generation and imagery (CBM_ENH; n = 53). Interpretation bias, RNT, and mood were assessed before and following 10 Internet-based sessions completed within a 1-month period. RNT and mood questionnaires were also completed at 1-month follow-up. RESULTS: After training, both forms of CBM-I (vs. control) facilitated more positive interpretations and reduced negative intrusions during a worry task. At 1-month follow-up, anxiety, depression, RNT, and worry in the past week were lower in the CBM-I than control conditions, but not rumination or trait worry. Compared with standard CBM-I, the augmented form facilitated more positive interpretations, reduced negative intrusions after training, and reduced trait rumination at 1-month follow-up, but it did not augment effects on trait worry, anxiety or depression. CONCLUSIONS: Interpretation bias maintains transdiagnostic RNT and Internet-based CBM-I can reduce longer-term RNT. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Thinking mindfully: How mindfulness relates to rumination and reflection in daily life.

Mindfulness is a state of awareness comprising an attentional focus on the present moment and a nonjudgmental stance. It is associated with affective well-being and assumed to facilitate adaptive emotion regulation. To support this claim at the within-person level, we investigated associations between 2 mindfulness facets (present-moment attention and nonjudgmental acceptance), 2 emotion-regulation strategies varying in adaptiveness (rumination and reflection), and positive and negative affect in everyday life using data from 2 experience-sampling (ESM) studies. Study 1 consisted of N = 70 students who completed 54 prompts on average. Study 2 consisted of N = 179 middle-aged adults who completed 69 prompts on average. Results from both studies were highly consistent: The mindfulness facet nonjudgmental acceptance was more strongly related to less concurrent rumination, whereas the mindfulness facet present-moment attention was related to more concurrent reflection. As predicted, both mindfulness facets interacted with rumination in the prediction of changes in affect. When individuals were in a more mindful state, rumination was less strongly associated with increases in negative affect, and was less strongly associated with decreases in positive affect. However, mindfulness interacted with reflection in the prediction of changes in affect in an unexpected way: At higher levels of nonjudgmental acceptance, reflection was no longer associated with changes in affect. Together, these results suggest that emotion regulation strategies can be more or less adaptive depending on the level of mindfulness. They also accord with the proposal that mindfulness inhibits maladaptive emotion regulation and its impact on affective well-being. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Mindfulness, rumination and post-traumatic growth in a Chinese cancer sample.

A multiple mediation structural equation model was used to test the relationship between mindfulness, deliberate rumination, intrusive rumination and post-traumatic growth (PTG) among Chinese cancer patients. Data were collected from 309 cancer patients in China (61.2% male, 38.8% female), who completed questionnaires comprising the Mindful Attention Awareness Scale, the Event Related Rumination Inventory and the Post-traumatic Growth Inventory. The multiple mediation structural equation model showed that deliberate rumination partially mediated the relationship between mindfulness and PTG. However, the mediatory effect of intrusive rumination was not significant. Our findings indicated that deliberate rumination functions as an essential mechanism in the relationship between mindfulness and PTG. The results showed that interventions to increase mindfulness are needed in order to encourage PTG.

Impact of imagery-enhanced interpretation training on offline and online interpretations in worry.

Worry and rumination are forms of repetitive negative thinking (RNT) that are maintained by negative interpretations and a predominance of abstract, verbal thinking. Hence, facilitating more positive interpretations and imagery-based thinking in combination may reduce RNT. Study 1 administered interpretation training with and without enhanced imagery, and an active control condition (designed not to change interpretations), in individuals with high levels of RNT (worry and/or rumination). Combining interpretation training with sustained imagery resulted in the highest levels of positive interpretation bias using an offline test of interpretation bias (when individuals have time to reflect). Study 2 investigated whether imagery-enhanced interpretation training influences online interpretations when ambiguous information is first encountered, indexed by reaction times and amplitude of the N400 event-related potential, as well as enhances offline positive interpretations in high worriers. It also examined whether imagery-enhanced interpretation training reduces negative thought intrusions associated with worry. Both online (reaction time) and offline interpretations were more positive following imagery-enhanced interpretation training, and negative thoughts were reduced, compared to the active control. However, no differences emerged on neurophysiological markers during the online task. Hence, brief interpretation training encompassing sustained imagery modifies online and offline interpretations, but further training may be required to impact upon neurophysiological measures.

Could worry and rumination mediate relationships between self-compassion and psychological distress in breast cancer survivors?

Many breast cancer (BCa) patients experience clinically significant anxiety and depression in survivorship. Self-compassion offers a bulwark to anxiety and depression in nonclinical, mental health, and some chronic physical health populations. We examined whether self-compassion predicted lower anxiety and depression symptoms in survivors and whether this might be mediated by lower worry and rumination. The design was a cross-sectional survey using self-report measures. Female adult BCa survivors of mixed stages who had finished primary surgical, radiotherapy, or chemotherapy treatments completed self-compassion subscales and worry, rumination, and anxiety and depression scales. Higher self-compassion subscale scores were negatively associated with anxiety and depression. Depressive brooding and worry mediated any effects of self-kindness and mindfulness on depression and anxiety, whereas common humanity directly predicted lower depression scores. Findings are consistent with the view that self-compassion reduces threat-related rumination and worry in BCa survivors, consequently reducing anxiety and depression. This may form a basis for prevention and treatment.

Clinical remission of a treatment-refractory individual with severe repetitive rituals and rumination.

BACKGROUND: Obsessive-compulsive disorder (OCD) is a severe chronic mental disorder and tends to be refractory to pharmacotherapy or psychotherapy. For treatment-refractory patients, neurosurgical interventions are options. 64 % of OCD patients who undergo neurosurgery still have greater than 16 in the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) after a long-term follow-up. Here, we reported a patient living with long-term OCD (20 years) who was refractory to pharmacotherapy, mindfulness-based psychotherapy, and neurosurgery that injured his bilateral anterior cingulates (AC) and caudate nucleus. METHODS: The patient accepted a novel psychotherapy named cognitive-coping therapy (CCT) and completed Y-BOCS, Hamilton depression rating scale, the Hamilton anxiety rating scale, social and occupational function assessment, and resting-state function magnetic resonance imaging scans (rs-fMRI) before and after 4-week CCT. RESULTS: His Y-BOCS score was reduced from 25 to 4. His depression score and anxiety score were reduced from 19 to 3 and from 12 to 3, respectively. The global assessment of functioning score increased from 32 to 88. CONCLUSIONS: The remission of the patient suggested that CCT could be an alternative intervention for treatment-refractory OCD and those with severe OCD could be cured in short-term.

Self-related processing in mindfulness-based interventions.

Self-related processing pertains to the complex construct of 'self', as studied across varied disciplines such as cognitive science, neuroscience, modern psychology (including clinical and behavioral psychology), and Western and Eastern philosophy. On a theoretical level, most contemporary models propose that mindfulness training impacts self-related processes. In this review, the empirical evidence for this hypothesis is examined and discussed. Overall, very few self-related processes have been measured in randomized controlled trials of mindfulness-based interventions to date, and, of those processes that have been measured, only negative self-rumination improved significantly. The data so far remain inconclusive as to whether mindfulness-based interventions have an impact on other self-related processes. Studies are especially needed on more basic levels of self such as embodiment and sense of agency.